Dysphagia Due to MS Associated With Reduced Swallowing-Related QoL
Dysphagia is a common symptom associated with multiple sclerosis and can present as a challenge in clinical practice.
Dysphagia resulting from multiple sclerosis is associated with lower scores on all measures of quality of life related to swallowing, according to a study published in Multiple Sclerosis and Related Disorders.
All data for this study were collected through patient-reported questionnaires in the multiple sclerosis clinic of a major hospital in Australia. Patients were at least 18 years old and had a confirmed diagnosis of multiple sclerosis. The period of the study was May to December 2016, and participants were included who had no other neurological conditions. The self-reported questionnaires given to participants asked about medical history, demographic details, type of multiple sclerosis, expanded disability status scale, and current comorbidities. Some questions from the 10-item Eating Assessment Tool were also included.
This study included 103 adults with multiple sclerosis, 81 (78.6%) of whom were women. In all, 38% reported problems with swallowing. This difficulty resulted in secondary effects such as mealtime anxiety, throat clearing, coughing, the tendency to choke on liquid and food, decreased desire to eat, and longer mealtimes. According to results of univariate analyses, the presence of dysphagia was not significantly associated with sex, time of diagnosis, type of multiple sclerosis, or age.
Approximately 60% of participants reported that their problem with swallowing is “a major distraction in their lives and that dealing with this problem is very difficult.” In addition, approximately 50% reported “feeling frustrated, discouraged, depressed and annoyed with their swallowing problems.” Nearly half of the participants reported fear of chocking and worrying about pneumonia. Almost 45% of participants stated they have lost enjoyment in eating, decreased desire to eat, and difficulty finding food to eat.
The study researchers conclude that "[adults] with [multiple sclerosis]-related dysphagia had reduced scores across all domains of swallowing-related quality of life. These findings support referral to speech-language pathologists for management of dysphagia from the early stages of the disease. Further work is required to determine whether early intervention for dysphagia can sustain or improve swallowing function as well as swallowing-related quality of life domains further into the disease course."
Alali D, Ballard K, Bogaardt H. The frequency of dysphagia and its impact on adults with multiple sclerosis based on patient-reported questionnaires. Mult Scler Relat Disord. 2018; 25:227-231.